We understand cancer is a scary thought but if you have a family history of oesophageal cancer or are experiencing any warning symptoms such as frequent heartburn it is worth seeing your doctor in order to be safe. The earlier cancer is detected the more treatable it is.
The oesophagus is the tube that carries food from your mouth to your stomach. Cancer can affect any part of this tube and the risk increases with age. It is important to see a GI doctor if you are experiencing problems swallowing or have new heartburn or changes to pre-existing heartburn symptoms.
In most cases, these symptoms won’t be due to oesophageal cancer but it is important to get them checked.
Consultation with a specialist and diagnosis is the first step to feeling better
The precise causes of oesophageal cancer are not known but certain factors are known to increase your risk.
These include:
Consequently, eating a healthy balanced diet, maintaining a healthy body weight and avoiding smoking can all help to reduce your chances of developing the disease.
In the early stages, oesophageal cancer does not tend to have any symptoms. As the cancer grows, however, it can cause the oesophagus to narrow, making it difficult for food to pass. This can lead to a range of symptoms including:
These symptoms require specialist medical attention and full investigation to accurately determine the stage of the disease and offer the appropriate treatment. As with most cancers, treatment is most successful when it is diagnosed at an early stage.
After taking a medical history and asking you to describe your symptoms, the doctor may refer you for diagnostic testing. The tests used to diagnose oesophageal cancer include:
Endoscopy
An endoscopy allows your doctor to look inside your oesophagus using a thin, flexible tube with a light and a camera (an endoscope). The endoscope is passed carefully down your throat towards your stomach. You will normally be given a local anaesthetic to numb your throat and you may also be given a sedative to help you relax. The procedure shouldn’t hurt but it may feel a bit uncomfortable. As well as looking inside your oesophagus, the doctor may also take small samples of tissue for analysis in the laboratory. This is called a biopsy.
Barium swallow
This involves drinking a harmless liquid called barium, which coats the lining of your oesophagus so that it shows up on an X-ray. X-rays are taken after you have swallowed the barium and these will show whether anything is blocking your oesophagus, which may indicate that you have a cancerous tumour. If oesophageal cancer is diagnosed, you will be offered further tests to assess the location and size of the tumour such as:
A CT scan – this type of scan takes a series of X-rays and puts them together to create a detailed 3D picture of the inside of your body.
A PET scan – a position emission tomography scan shows how far cancer has spread.
An endoscopic ultrasound scan – uses sound waves to create an image of your oesophagus and surrounding organs.
Laparoscopy – this is performed under general anaesthetic. It involves making a small incision in your skin and inserting a thin, flexible tube with a camera at one end to see inside your oesophagus.
The treatment you are offered will depend on how far your cancer has spread. Stage 1 cancer is in the earliest stages through to stage 4, which is advanced cancer.
Among the treatments for oesophageal cancer are:
Surgery – you might be offered surgery to remove the section of the oesophagus that contains the tumour (this is the main treatment for early-stage oesophageal cancer).
EMR (endoscopic mucosal resection) – may also be offered for very early cancers. This involves cutting out the tumour during endoscopy. Stents may be used for more advanced oesophageal cancers. This involves inserting a hollow tube called a stent into the oesophagus. The stent expands and keeps the oesophagus open.
Chemotherapy – this involves taking medicines that kill cancer cells or prevent them from multiplying. The medicines are given into the vein or taken as tablets.
Radiotherapy – this uses radiation to kill cancer cells and shrink tumours. It may be used in combination with chemotherapy. Beams of radiation are directed at your oesophagus or by placing small pieces of radioactive material into your oesophagus.
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